Koshy John, DPT, PTA, MS, ATC

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

014613 Issued in NY

Practice address

1100 Stewart Ave Ste B
Garden City, NY 11530-4839

Phone

(917) 609-4684

NPI assigned

Jul 8, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1531008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1417443904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "584 BELLMORE AVE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115544711",
            "telephone_number": "917-609-4684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 STEWART AVE STE B",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304839",
            "telephone_number": "917-609-4684"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "584 Bellmore Ave",
            "address_purpose": "LOCATION",
            "city": "East Meadow",
            "state": "NY",
            "postal_code": "115544711",
            "country_code": "US",
            "telephone_number": "917-609-4684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHN",
        "first_name": "KOSHY",
        "name_prefix": "Dr.",
        "credential": "DPT, PTA, MS, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-08",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "014613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Shi Yeong Jo, LMFT
• Sanjay P Jobanputra, M.D.
• Amanda Joglar, LMSW
• Rupinder Johal, M.D.
• Alicia John, PTA
• Jillian Johnson
• Laurie Shepherd Johnson, PHD, LMHC,NCC
• Marcus D Johnson, DDS, MSD
• Nancy E Johnson, LCSW
• Sandra C. Johnson, D.D.S.

• Physical Therapy Assistant in Garden City, NY
• Providers in Garden City, NY by specialty
• Physical Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.